Progettazione di un sistema per patient-reported outcome utilizzabile anche su dispositivi mobili

In questo elaborato prenderemo in esame la questione della progettazione di un sistema software atto a gestire alcuni dei problemi legati alla raccolta dei dati in ambito medico. Da tempo infatti si è capita l'importanza di una speciale tecnica di raccolta dei dati clinici, nota in letteratura col nome di "patient-reported outcome", che prevede che siano i pazienti stessi a fornire le informazioni circa l'andamento di una cura, di un test clinico o, più semplicemente, informazioni sul loro stato di salute fisica o mentale. Vedremo in questa trattazione come ciò sia possibile e, soprattutto, come le tecniche e le tecnologie informatiche possano dare un grande contributo ai problemi di questo ambito. Mostreremo non solo come sia conveniente l'uso, in campo clinico, di tecniche automatiche di raccolta dei dati, della loro manipolazione, aggregazione e condivisione, ma anche come sia possibile realizzare un sistema moderno che risolva tutti questi problemi attraverso l'utilizzo di tecnologie esistenti, tecniche di modellazione dei dati strutturati e un approccio che, mediante un processo di generalizzazione, aiuti a semplificare lo sviluppo del software stesso.

La Ricostruzione 3D di Bologna nel XVI Secolo

Il lavoro presentato ha come oggetto la ricostruzione tridimensionale della città di Bologna nella sua fase rinascimentale. Tale lavoro vuole fornire un modello 3D delle architetture e degli spazi urbani utilizzabile sia per scopi di ricerca nell’ambito della storia delle città sia per un uso didattico-divulgativo nel settore del turismo culturale. La base del lavoro è una fonte iconografica di grande importanza: l’affresco raffigurante Bologna risalente al 1575 e situato in Vaticano; questa è una veduta a volo d’uccello di grandi dimensioni dell’intero tessuto urbano bolognese all’interno della terza cerchia di mura. In esso sono rappresentate in maniera particolareggiata le architetture civili e ecclesiastiche, gli spazi ortivi e cortilivi interni agli isolati e alcune importanti strutture urbane presenti in città alla fine del Cinquecento, come l’area portuale e i canali interni alla città, oggi non più visibili. La ricostruzione tridimensionale è stata realizzata tramite Blender, software per la modellazione 3D opensource, attraverso le fasi di modellazione, texturing e creazione materiali (mediante campionamento delle principali cromie presenti nell’affresco), illuminazione e animazione. Una parte della modellazione è stata poi testata all’interno di un GIS per verificare l’utilizzo delle geometrie 3D come elementi collegabili ad altre fonti storiche relative allo sviluppo urbano e quindi sfruttabili per la ricerca storica. Grande attenzione infine è stata data all’uso dei modelli virtuali a scopo didattico-divulgativo e per il turismo culturale. La modellazione è stata utilizzata all’interno di un motore grafico 3D per costruire un ambiente virtuale interattivo nel quale un utente anche non esperto possa muoversi per esplorare gli spazi urbani della Bologna del Cinquecento. In ultimo è stato impostato lo sviluppo di un’applicazione per sistemi mobile (Iphone e Ipad) al fine di fornire uno strumento per la conoscenza della città storica in mobilità, attraverso la comparazione dello stato attuale con quello ricostruito virtualmente.

Thinkmix: dall'idea alla progettazione dello story network

Thinkmix è un network con componenti social che permette agli utenti di creare storie collaborando. La tesi illustra tutti gli step che hanno portato alla realizzazione di questo network: l'idea, la progettazione, lo sviluppo e la pubblicazione. Ritengo si tratti di un progetto ben riuscito e completo che mi ha permesso di esprimere totalmente le capacità acquisite durante il corso nelle varie materie (e non unicamente nella materia di riferimento) e di avvicinarmi a tematiche esterne a una laurea triennale (sicurezza informatica, marketing, acquisto e gestione di server dedicati, burocrazia per la pubblicazione di applicazione iOS e sito web con dominio).

Fog escaping: un'applicazione di mobile data CrowdSourcing per il supporto alla mobilità veicolare

In questa Tesi di laurea, si è affrontato il problema della mobilità veicolare in caso di nebbie. Si è quindi sviluppato un prototipo con architettura Client-Server, che si è soffermato maggiormente sull’analisi dei dati per la creazione di un percorso alternativo. Si è preso in considerazione il sistema operativo mobile di Apple, iOS7 che rappresenta uno dei Sistemi Operativi mobili maggiormente presenti sul mercato oggigiorno e che possiede un buon bacino di utenze. La parte Server è stata sviluppata secondo l’architettura REST; è presente un Server HTTP che riceve richieste e risponde in modo adeguato ai Client tramite lo scambio bidirezionale di dati in formato JSON. Nella parte Server è inclusa la base di dati: un componente molto importante poiché implementa al suo interno, parte della logica di Sistema tramite stored procedure. La parte Client è un’applicazione per dispositivi iPad e iPhone chiamata Fog Escaping; essa è stata sviluppata secondo il pattern MVC (Model- View-Controller). Fog Escaping implementa un algoritmo Greedy di ricerca del percorso alternativo, che può essere utilizzato per diverse tipologie di applicazioni.

THE EFFECTS OF WEB-BASED TECHNOLOGICAL RESOURCES IN A RURAL SCIENCE CLASSROOM

Today’s technology is evolving at an exponential rate. Everyday technology is finding more inroads into our education system. This study seeks to determine if having access to technology, including iPad tablets and a teacher's physical science webpage resources (videos, PowerPoint® presentations, and audio podcasts), assists ninth grade high school students in attaining greater comprehension and improved scientific literacy. Comprehension of the science concepts was measured by comparing current student pretest and post test scores on a teacher-written assessment. The current student post test scores were compared with prior classes’ (2010-2011 and 2009-2010) to determine if there was a difference in outcomes between the technology interventions and traditional instruction. Students entered responses to a technology survey that measured intervention usage and their perception of helpfulness of each intervention. The current year class’ mean composite scores, between the pretest and post test increased by 6.9 points (32.5%). Student composite scores also demonstrated that the interventions were successful in helping a majority of students (64.7%) attain the curriculum goals. The interventions were also successful in increasing student scientific literacy by meeting all of Bloom's cognitive levels that were assessed. When compared with prior 2010-2011 and 2009-2010 classes, the current class received a higher mean post test score indicating a positive effect of the use of technological interventions. The survey showed a majority of students utilized at least some of the technology interventions and perceived them as helpful, especially the videos and PowerPoint® presentations.

Integrated data acquisition and processing to determine metabolite contents, relaxation times, and macromolecule baseline in single examinations of individual subjects

Absolute quantitation of clinical (1)H-MR spectra is virtually always incomplete for single subjects because the separate determination of spectrum, baseline, and transverse and longitudinal relaxation times in single subjects is prohibitively long. Integrated Processing and Acquisition of Data (IPAD) based on a combined 2-dimensional experimental and fitting strategy is suggested to substantially improve the information content from a given measurement time. A series of localized saturation-recovery spectra was recorded and combined with 2-dimensional prior-knowledge fitting to simultaneously determine metabolite T(1) (from analysis of the saturation-recovery time course), metabolite T(2) (from lineshape analysis based on metabolite and water peak shapes), macromolecular baseline (based on T(1) differences and analysis of the saturation-recovery time course), and metabolite concentrations (using prior knowledge fitting and conventional procedures of absolute standardization). The procedure was tested on metabolite solutions and applied in 25 subjects (15-78 years old). Metabolite content was comparable to previously found values. Interindividual variation was larger than intraindividual variation in repeated spectra for metabolite content as well as for some relaxation times. Relaxation times were different for various metabolite groups. Parts of the interindividual variation could be explained by significant age dependence of relaxation times.

Iowa State Daily (March 22, 2012)

ContentsSo Long, RoycePolitics of parenting in 'Carnage'Blood drive helps those in needBattle: Is the new iPad worth the upgrade? Bride-to-be juggles soccer and ceremony

Quality Control for SP Performance Regarding Patient Portrayal in a High-Stakes OSCE

Introduction Since the quality of patient portrayal of standardized patients (SPs) during an Objective Structured Clinical Exam (OSCE) has a major impact on the reliability and validity of the exam, quality control should be initiated. Literature about quality control of SP’s performance focuses on feedback [1, 2] or completion of checklists [3, 4]. Since we did not find a published instrument meeting our needs for the assessment of patient portrayal, we developed such an instrument after being inspired by others [5] and used it in our high-stakes exam. Methods SP trainers from all five Swiss medical faculties collected and prioritized quality criteria for patient portrayal. Items were revised with the partners twice, based on experiences during OSCEs. The final instrument contains 14 criteria for acting (i.e. adequate verbal and non-verbal expression) and standardization (i.e. verbatim delivery of the first sentence). All partners used the instrument during a high-stakes OSCE. Both, SPs and trainers were introduced to the instrument. The tool was used in training (more than 100 observations) and during the exam (more than 250 observations). FAIR_OSCE The list of items to assess the quality of the simulation by SPs was primarily developed and used to provide formative feedback to the SPs in order to help them to improve their performance. It was therefore named “Feedbackstruckture for the Assessment of Interactive Role play in Objective Structured Clinical Exams (FAIR_OSCE). It was also used to assess the quality of patient portrayal during the exam. The results were calculated for each of the five faculties individually. Formative evaluation was given to the five faculties with individual feedback without revealing results of other faculties other than overall results. Results High quality of patient portrayal during the exam was documented. More than 90% of SP performances were rated to be completely correct or sufficient. An increase in quality of performance between training and exam was noted. In example the rate of completely correct reaction in medical tests increased from 88% to 95%. 95% completely correct reactions together with 4% sufficient reactions add up to 99% of the reactions meeting the requirements of the exam. SP educators using the instrument reported an augmentation of SPs performance induced by the use of the instrument. Disadvantages mentioned were high concentration needed to explicitly observe all criteria and cumbersome handling of the paper-based forms. Conclusion We were able to document a very high quality of SP performance in our exam. The data also indicate that our training is effective. We believe that the high concentration needed using the instrument is well invested, considering the observed augmentation of performance. The development of an iPad based application for the form is planned to address the cumbersome handling of the paper.

FAIR_OSCE – Feedback structure for assessment of interactive roleplay in Objective Structured Clinical Exams

Introduction Since the quality of patient portrayal of standardized patients (SPs) during an Objective Structured Clinical Exam (OSCE) has a major impact on the reliability and validity of the exam, quality control should be initiated. Literature about quality control of SPs’ performance focuses on feedback [1, 2] or completion of checklists [3, 4]. Since we did not find a published instrument meeting our needs for the assessment of patient portrayal, we developed such an instrument after being inspired by others [5] and used it in our high-stakes exam. Project description SP trainers from five medical faculties collected and prioritized quality criteria for patient portrayal. Items were revised twice, based on experiences during OSCEs. The final instrument contains 14 criteria for acting (i.e. adequate verbal and non-verbal expression) and standardization (i.e. verbatim delivery of the first sentence). All partners used the instrument during a high-stakes OSCE. SPs and trainers were introduced to the instrument. The tool was used in training (more than 100 observations) and during the exam (more than 250 observations). Outcome High quality of SPs’ patient portrayal during the exam was documented. More than 90% of SP performances were rated to be completely correct or sufficient. An increase in quality of performance between training and exam was noted. For example, the rate of completely correct reaction in medical tests increased from 88% to 95%. Together with 4% of sufficient performances these 95% add up to 99% of the reactions in medical tests meeting the standards of the exam. SP educators using the instrument reported an augmentation of SPs’ performance induced by the use of the instrument. Disadvantages mentioned were the high concentration needed to observe all criteria and the cumbersome handling of the paper-based forms. Discussion We were able to document a very high quality of SP performance in our exam. The data also indicates that our training is effective. We believe that the high concentration needed using the instrument is well invested, considering the observed enhancement of performance. The development of an iPad-based application for the form is planned to address the cumbersome handling of the paper.

Una aplicación específica de las IDE: la información aeronáutica

El conjunto de actividades ligadas al transporte aéreo se ha convertido, a nivel global, en una importante fuente de recursos económicos, generación de empleo e incremento de la calidad de vida de los ciudadanos. Sin embargo, la situación crónica de saturación del espacio aéreo y de los propios aeropuertos limita enormemente el potencial crecimiento económico mundial basado en este sector estratégico del transporte. Como efecto colateral de esta saturación, se producen graves daños medioambientales debidos fundamentalmente, a la emisión directa a la atmósfera de mucha mayor cantidad de gases de efecto invernadero de la estrictamente necesaria. La solución al problema no es abordable exclusivamente a través de la construcción de nuevas infraestructuras aeroportuarias o la ampliación de las ya existentes. Los organismos mundiales relacionados con la aviación civil han diagnosticado que la forma anacrónica en la que actualmente se está gestionando la información aeronáutica (IA) impide que los proveedores de servicios de navegación aérea puedan tratar de forma eficiente y segura un mayor volumen de tránsito aéreo en el mismo espacio y lapso de tiempo. En definitiva, se advierte que la actual falta de eficiencia de la gestión de IA constriñe de forma notable el verdadero potencial del sistema aéreo mundial. Para solucionar este problema, se encuentra en marcha un ambicioso programa de trabajo que pretende mejorar la situación actual, dando respuesta a la necesidad de una interoperabilidad mundial desde un punto de vista análogo al que promueven las IDE en otros campos temáticos. Denominado genéricamente transición de AIS (Servicios de Información Aeronáutica) a AIM (Gestión de la Información Aeronáutica), este proceso está liderado por la Organización de Aviación Civil Internacional (OACI), encargada de su tutela y coordinación con los estados para evitar en lo posible evoluciones divergentes. Basada en la futura puesta en marcha de un modelo mundial de intercambio de datos aeronáuticos normalizados, el avance de esta iniciativa está obligando a los servicios AIS a replantearse la forma en la que, hasta el momento, publican y difunden el contenido de las denominadas Publicaciones de Información Aeronáutica (AIP). Todavía hoy (mediados de 2011), las AIS publican su cartografía en formato papel y estos mapas son de uso obligatorio en todos los vuelos de transporte de pasajeros que realicen las compañías aéreas. Aunque nada impide que los pilotos puedan llevar otra información adicional en instrumentos electrónicos propios (ordenadores portátiles, teléfonos, tabletas tipo iPad, y otros), el uso de los mapas en papel sigue siendo obligatorio. Esto arrastra algunas consecuencias relacionadas con su manejo (la cabina del piloto es muy pequeña), con la lectura de los mapas (hay cada vez más información en los mapas), con su actualización (hay que versionar constantemente los mapas para incorporar novedades con el gasto de impresión y distribución que supone) y con otros aspectos que pueden ser fácilmente mejorables por medio de las tecnologías emergentes, como por ejemplo el acceso ubicuo a la información espacial más actual. Entre los cambios que impulsará la iniciativa del cambio de AIS a AIM, está el que los mapas usados por los pilotos y otros técnicos de IA, dejarán de concebirse como productos terminales y cerrados para evolucionar hacia el conocido formato de datos distribuidos e interoperables que auspician las IDE, logrando con ello integrar la información, contenida en la definición de diferentes flujos de trabajo dentro del campo aeronáutico, de forma directa, transparente y eficiente.

Hacia "augmented home": hitos antecedentes

Una vez que el tiempo ha superado al espacio, la casa del futuro es ampliada en torno al recorrido del ipad y el smartphone evolucionado que se convierte en interfaz entre el cuerpo y la ciudad. Augmented home se entiende como el tiempo doméstico en un sistema integrado de cuerpo e información.

The secreted Ipa complex of Shigella flexneri promotes entry into mammalian cells.

The bacterial pathogen Shigella flexneri causes bacillary dysentery in humans by invading coloncytes. Upon contact with epithelial cells, S. flexneri elicits localized plasma membrane projections sustained by long actin filaments which engulf the microorganism. The products necessary for Shigella entry include three secretory proteins: IpaB, IpaC, and IpaD. Extracellular IpaB and IpaC associate in a soluble complex, the Ipa complex. We have immunopurified this Ipa complex on latex beads and found that they were efficiently internalized into HeLa cells. Like S. flexneri entry, uptake of the beads bearing the Ipa complex was associated with membrane projections and polymerization of actin at the site of cell-bead interaction and was dependent on small Rho GTPases. These results indicate that a secreted factor can promote S. flexneri entry into epithelial cells.

Disulfide oxidoreductase activity of Shigella flexneri is required for release of Ipa proteins and invasion of epithelial cells.

Secretion of IpaB, IpaC, and IpaD proteins of Shigella flexneri, essential for the invasion of epithelial cells, requires a number of proteins encoded by the spa and mxi loci on the large plasmid. Introduction of dsbA::Tn5 into S.flexneri from Escherichia coli K-12 reduced invasiveness, which resulted from a decrease in the capacity to release IpaB, IpaC, and IpaD proteins into the external medium. Examination of the surface-presented Ipa proteins of the dsbA mutant, however, revealed Ipa proteins at levels similar to those on wild-type cells. Since the defective phenotype was similar to that of the spa32 mutant of S. flexneri and the Spa32 sequence possessed two Cys residues, the effect of dsbA mutation of the folding structure of Spa32 under reducing conditions and on the surface expression of Spa32 was investigated. The results indicated that Spa32 was a disulfide-containing protein whose correctly folded structure was required for its presentation on the outer membrane. Indeed, replacing either one of the two Cys residues in Spa32 with Ser by site-directed mutagenesis reduced its capacity to release Ipa proteins into the external medium and led to the accumulation of Spa32 protein in the periplasm. These results indicated that the DsbA protein performs an essential function during the invasion of mammalian cells, by facilitating transport of the Spa32 protein across the outer membrane.

Fundamentos de percepción visual

IMPORTANTE: CÓMO LEERLO. El libro se puede descargar desde el Repositorio de la Universidad de Alicante. Al tratarse de un libro con gran número de animaciones, gifs, vídeos y enlaces a internet, es conveniente abrirlo mediante un lector para epub3, aunque en cualquier otro lector la parte de texto es totalmente accesible. Está optimizado para el lector ibooks del iPad, se puede leer por ejemplo mediante el lector Gitden para Android, mediante los lectores Azardi y Adobe Digital Edition 4.5 para PC o añadiendo el complemento para epub en el navegador Mozilla. Para los usuarios de iPad: al bajar el archivo epub desde la plataforma RUA directamente al dispositivo no se reconoce el formato, por lo que la aplicación ibooks no lo abre. Para evitarlo, recomendamos bajar el fichero en un ordenador y llevarlo al iPad, vía conexión por cable o a través de una nube de datos (la aplicación Dropbox es gratis).

HELPING YOUTH WITH AUTISM SPECTRUM DISORDER DEVELOP SOCIAL COMPETENCE IN COMMUNITY-BASED SETTINGS

The purpose of the current dissertation is to identify the features of effective interventions by exploring the experiences of youth with ASD who participate in such interventions, through two intervention studies (Studies 1 and 2) and one interview study (Study 3). Studies 1 and 2 were designed to support the development of social competence of youth with ASD through Structured Play with LEGO TM (Study 1, 12 youths with ASD, ages 7–12) and Minecraft TM (Study 2, 4 youths with ASD, ages 11–13). Over the course of the sessions, the play of the youth developed from parallel play (children playing alone, without interacting) to co-operative play (playing together with shared objectives). The results of Study 2 showed that rates of initiations and levels of engagement increased from the first session to the final session. In Study 3, 12 youths with ASD (ages 10–14) and at least one of their parents were interviewed to explore what children and their parents want from programs designed to improve social competence, which activities and practices were perceived to promote social competence by the participants, and which factors affected their decisions regarding these programs. The adolescents and parents looked for programs that supported social development and emotional wellbeing, but did not always have access to the programs they would have preferred, with factors such as cost and location reducing their options. Three overarching themes emerged through analysis of the three studies: (a) interests of the youth; (b) structure, both through interactions and instruction; and (c) naturalistic settings. Adolescents generally engage more willingly in interventions that incorporate their interests, such as play with Minecraft TM in Study 2. Additionally, Structured Play and structured instruction were crucial components of providing safe and supportive contexts for the development of social competence. Finally, skills learned in naturalistic settings tend to be applied more successfully in everyday situations. The themes are analysed through the lens of Vygotsky’s (1978) perspectives on learning, play, and development. Implications of the results for practitioners and researchers are discussed.